Surgically implantable peritoneal dialysis apparatus

Abstract

A surgically implantable apparatus for subcutaneous placement in the body of a patient and by which peritoneal dialysis may be performed with minimal risk of infection, the apparatus being connected to a catheter extending into the peritoneal cavity and having a needle-impenetrable reservoir, a needle-penetrable covering over the opening of the reservoir, and an essentially nonyielding support extending across reservoir opening beneath and contiguous to the needle-penetrable covering to prevent sagging of body tissues; and a method for performing peritoneal dialysis by means of the apparatus.

I claim: 
     
       1. Surgically implantable apparatus adapted for subcutaneous placement in the body of a patient and by which peritoneal dialysis may be performed, said apparatus comprising: reservoir means defining a first wall, and a peripheral wall formed at the periphery of the first wall at about right angles thereto and extending a predetermined distance therefrom and defining at its free end of opening opposite the first wall, said reservoir means being formed from a needle-impenetrable material;   needle-penetrable covering means extending across the opening of said reservoir means and suitably secured to said peripheral wall and being sufficiently permeable to allow body tissue ingrowth to occur and to seal the surface of said covering means when the apparatus is implanted in a patient;   an essentially nonyielding support means for said needle-penetrable covering means extending across said opening beneath and contiguous with the undersurface of said covering means and suitably fixed to said peripheral wall and spaced at predetermined intervals across the undersurface of said covering means, said essentially nonyielding support means comprising a series of spaced bars formed in a predetermined pattern; and   means defining a nozzle extending from said reservoir means and having an opening extending therethrough and into the interior of said reservoir means, said nozzle being adapted to receive thereover one end of a catheter that will extend into the peritoneal cavity of the patient.   
     
     
       2. A surgically implantable apparatus as defined in claim 1, wherein said peripheral wall has a flange formed at its free end around its periphery and extending outwardly from the peripheral wall at about right angles thereto, said flange defining through its surface at predetermined spaced intervals a series of holes of a size suitable to receive therethrough a suturing thread.   
     
     
       3. A surgically implantable apparatus as defined in claim 1 wherein said reservoir means is formed from titanium. 
     
     
       4. A surgically implantable apparatus as defined in claim 2 wherein said covering means is suitably secured to said flange. 
     
     
       5. A surgically implantable apparatus as defined in claim 1 wherein said nozzle extends from said peripheral wall. 
     
     
       6. A surgically implantable apparatus as defined in claim 1 wherein said first wall of said reservoir means is circular and said peripheral wall extends circumferentially around the periphery of said first wall. 
     
     
       7. A surgically implantable apparatus as defined in claim 1 wherein said series of spaced bars are spaced parallel bars. 
     
     
       8. Method of performing peritoneal dialysis on a patient in whose body the apparatus defined in claim 1 has been suitably surgically implanted in such manner that said opening and said needle-penetrable covering means of the apparatus are spaced below and parallel to the skin of the patient and a catheter has been connected to the nozzle means of the apparatus and extended from the apparatus and into the peritoneal cavity of the patient, the method comprising: providing on the surface of the skin of the patient at a location overlying the opening in the surgically implanted apparatus a diagram corresponding approximately in size and configuration to said opening, the diagram being divided into approximately equal segments in size and configuration and having a series of marked points within each segment at predetermined spaced intervals, each marked point designating the site for the entry of a needle-injection and the spaced intervals corresponding to the spacing necessary to avoid a yet unhealed area caused by more recent needle-injections; and   making each needle-injection at a marked point different from the previous needle-injection and following a predetermined path from one marked point to the next marked point within each said segment.   
     
     
       9. The method according to claim 8 wherein said diagram is in the configuration of a circle and said series of marked points are located at spaced intervals along concentric circular paths relative to the center of said opening, and said circle is divided into quarter segments.